| NPI | 1356474274 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NC 2005-01190) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2005-01190) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2023-03-07 |