| NPI | 1053331900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX M6564) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MD426665) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2020-01-30 |