| NPI | 1205299310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: VA 0101281119) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WA MD61271065) |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2024-07-12 |