| NPI | 1306997515 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX F9664) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MS 18384) |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2021-11-30 |