| NPI | 1306251947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WI 75334) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI 4301105515) |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2022-10-18 |