| NPI | 1063465615 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MA 231794) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: AZ 35434) |
| 207T00000X Neurological Surgery (Licence: WI 41213020) | |
| 207T00000X Neurological Surgery (Licence: WA MD00039363) | |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2022-08-19 |