| NPI | 1356445712 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TN MD38608) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: KY 50622) |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2019-06-13 |