| NPI | 1164624573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: ID M-15651) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TX N9095) |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2024-04-16 |