| NPI | 1295894731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: GA 70475) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TX N5820) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2020-04-14 |