| NPI | 1013354786 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: VA 0101269164) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WV 29729) |
| Enumeration Date | 2013-06-04 |
| Last Update Date | 2023-07-28 |