| NPI | 1386623726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MT 10483) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WY 7072A) |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2022-02-08 |