| NPI | 1154423762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: DC MD038939) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WA ML20007453) |
| Enumeration Date | 2006-09-03 |
| Last Update Date | 2020-08-11 |