| NPI | 1164402368 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: VA 0101052228) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WV 29588) |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2023-07-26 |