| NPI | 1205480704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: ND 16383) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MN 65364) |
| Enumeration Date | 2019-08-01 |
| Last Update Date | 2023-09-06 |