| NPI | 1326109497 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX 43964) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MA 214475) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2020-01-30 |