| NPI | 1306810973 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WI 69315) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD420967) |
| 207T00000X Neurological Surgery (Licence: WV 24189) | |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2019-06-20 |