| NPI | 1013964493 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MO 2006005747) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: AR E-4936) |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2021-09-30 |