| NPI | 1104115385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: VA 0101274032) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TN 57000) |
| 207T00000X Neurological Surgery (Licence: MS 25754) | |
| Enumeration Date | 2011-03-28 |
| Last Update Date | 2022-05-13 |