| NPI | 1063414803 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OR MD25770) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MO 2000149847) |
| 207T00000X Neurological Surgery (Licence: GA 054523) | |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2021-12-06 |