| NPI | 1134276777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA A69623) |
| Additional Taxonomies | 2085N0700X (Licence: CA A69623) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A69623) | |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2024-04-26 |