| NPI | 1376769471 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: ND PT20164) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CO 48802) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2023-08-22 |