| NPI | 1093923831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX 47027) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: AL 26790) |
| 207T00000X Neurological Surgery (Licence: WA 60205325) | |
| 207T00000X Neurological Surgery (Licence: NH 15615) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2020-09-02 |