| NPI | 1013370089 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NC 2019-01905) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: SC 89759) |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2024-02-27 |