| NPI | 1386832970 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NM MD2020-0136) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: UT 294901-1205) |
| 207T00000X Neurological Surgery (Licence: NY 290897-1) | |
| 207T00000X Neurological Surgery (Licence: WI 55955) | |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2023-10-20 |