| NPI | 1124226394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CT 62295) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MI 4301090199) |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2019-02-13 |