| NPI | 1417984329 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: KY 48914) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TN MD40674) |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2019-01-26 |