| NPI | 1356632202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX S7306) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA A123883) |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A123883) | |
| Enumeration Date | 2011-04-27 |
| Last Update Date | 2020-07-23 |