| NPI | 1194932996 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MO 2011015498) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: IA R-7468) |
| 207T00000X Neurological Surgery (Licence: IA 39180) | |
| 207T00000X Neurological Surgery (Licence: AZ 43769) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2024-05-15 |