| NPI | 1235165705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CO 39816) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MO 2021048634) |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2022-06-07 |