| NPI | 1285802801 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: GA 85703) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: GA 002213) |
| 207T00000X Neurological Surgery (Licence: TX P9918) | |
| Enumeration Date | 2008-02-17 |
| Last Update Date | 2020-12-04 |