| NPI | 1427012921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX N7599) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA G059721) |
| 207T00000X Neurological Surgery (Licence: IL 036-082040) | |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2021-05-07 |