| NPI | 1154651867 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NC 2016-00515) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MI 4301119295) |
| Enumeration Date | 2009-12-31 |
| Last Update Date | 2023-11-03 |