| NPI | 1083875744 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: SD 9575) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CO 50883) |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2020-02-28 |