| NPI | 1205270477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX T3109) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TX BP10049681) |
| Enumeration Date | 2013-04-18 |
| Last Update Date | 2023-03-01 |