| NPI | 1134530876 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NC 2021-01163) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NC 201686) |
| Enumeration Date | 2014-05-15 |
| Last Update Date | 2021-08-07 |