| NPI | 1376535492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WI 43655) |
| Additional Taxonomies | 208600000X Surgery (Licence: WI 43655) |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2021-12-20 |