| NPI | 1164701538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MI 4301510373) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WA TR60221957) |
| 207T00000X Neurological Surgery (Licence: AR E-8158) | |
| Enumeration Date | 2011-08-16 |
| Last Update Date | 2024-05-22 |