| NPI | 1417309097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MO 2018024718) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MA 272826) |
| 208600000X Surgery (Licence: IL 125068678) | |
| Enumeration Date | 2016-07-07 |
| Last Update Date | 2018-07-10 |