| NPI | 1336342419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PR 16773) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: GA 69203) |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2022-03-02 |