| NPI | 1326246836 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: SC 85541) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: KY 46283) |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2022-02-04 |