| NPI | 1295117620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CO DR.0067120) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: NC 2019-00242) |
| Enumeration Date | 2015-06-22 |
| Last Update Date | 2021-09-16 |