| NPI | 1326068669 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: SC 29442) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: GA 057641) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2023-05-24 |