| NPI | 1235664699 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX BP10064494) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ R76116) |
| Enumeration Date | 2017-04-24 |
| Last Update Date | 2018-06-05 |