| NPI | 1336222900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NC 2015-01713) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: FL ME89860) |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2020-10-25 |