| NPI | 1023308368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: VA 0102205158) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MO 2017010646) |
| Enumeration Date | 2011-04-07 |
| Last Update Date | 2020-07-17 |