| NPI | 1386808467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX 45327) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX 45327) |
| Enumeration Date | 2008-07-17 |
| Last Update Date | 2021-12-03 |