| NPI | 1356758692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CO 59615) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WA FE60437232) |
| Enumeration Date | 2014-07-18 |
| Last Update Date | 2020-03-25 |