| NPI | 1073779435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MI 4301503557) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: KS 04-42333) |
| 207T00000X Neurological Surgery (Licence: OR MD187909) | |
| 207T00000X Neurological Surgery (Licence: WA MD60267049) | |
| Enumeration Date | 2008-08-05 |
| Last Update Date | 2024-05-20 |