| NPI | 1083141899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX T2156) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: FL UO5370) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2023-06-22 |