| NPI | 1174985592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: KY 58520) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: KY R4178) |
| 207T00000X Neurological Surgery (Licence: KY TP654) | |
| Enumeration Date | 2016-03-24 |
| Last Update Date | 2023-09-25 |