| NPI | 1174789416 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: GA 74992) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MS 23117) |
| Enumeration Date | 2008-08-06 |
| Last Update Date | 2023-09-14 |