| NPI | 1386850006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NM MD2021-1076) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CO DR.0059830) |
| 207T00000X Neurological Surgery (Licence: AZ 41118) | |
| 207T00000X Neurological Surgery (Licence: GU M-2305) | |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2022-03-29 |