NPI | 1235525163 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WA 61259064) |
Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD61259064) |
Enumeration Date | 2015-04-07 |
Last Update Date | 2022-06-06 |