| NPI | 1295113405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CO DR.0070365) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TN 64850) |
| Enumeration Date | 2015-05-08 |
| Last Update Date | 2023-06-20 |