| NPI | 1174863906 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: GA 94418) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NC 218481) |
| Enumeration Date | 2013-02-14 |
| Last Update Date | 2023-07-06 |