| NPI | 1457459174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: SC 83104) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: KY 40314) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2023-02-14 |