| NPI | 1104547009 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MN 77440) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MN 33393) |
| Enumeration Date | 2022-09-08 |
| Last Update Date | 2024-07-31 |