| NPI | 1205271236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA A139840) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: AZ 64617) |
| Enumeration Date | 2013-05-03 |
| Last Update Date | 2023-10-31 |