| NPI | 1194703025 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX N0550) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MN 46429) |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2024-02-20 |