| NPI | 1275947038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WA OP61049724) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MO 2018042199) |
| Enumeration Date | 2014-06-19 |
| Last Update Date | 2024-04-15 |