| NPI | 1225479520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NC 202101178) |
| Additional Taxonomies | 174400000X Specialist (Licence: 4301102913) |
| 207T00000X Neurological Surgery (Licence: MN 67097) | |
| Enumeration Date | 2013-07-15 |
| Last Update Date | 2024-06-19 |