| NPI | 1154374502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX F9813) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: TX F9813) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2022-01-28 |