| NPI | 1326466376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX T9112) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WA MD61154464) |
| Enumeration Date | 2014-04-06 |
| Last Update Date | 2022-11-22 |