| NPI | 1205032034 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PR 14227) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: PR 14227) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2024-02-01 |