| NPI | 1144660390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WA MD61164163) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MT207376) |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2021-07-14 |