| NPI | 1447217666 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: VA 0101261872) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: SC 21814) |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2021-09-24 |