| NPI | 1083870497 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA C135229) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TX N0619) |
| 207T00000X Neurological Surgery (Licence: IL 036111490) | |
| Enumeration Date | 2008-08-05 |
| Last Update Date | 2021-04-01 |