| NPI | 1356559199 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX N1587) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: AL 26226) |
| 207T00000X Neurological Surgery (Licence: CO 47893) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2025-01-17 |