| NPI | 1194162834 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: GA 97655) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: IA R-9702) |
| Enumeration Date | 2013-06-03 |
| Last Update Date | 2023-12-05 |