| NPI | 1346488038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX P5281) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MN 21096) |
| 207T00000X Neurological Surgery (Licence: NM MD2014-0057) | |
| Enumeration Date | 2009-02-03 |
| Last Update Date | 2018-06-25 |