| NPI | 1184642175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MO 2003009178) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: AR E11207) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2019-07-08 |