| NPI | 1164472072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: AR C5586) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: ND 14822) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2023-05-11 |