| NPI | 1457593428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: KY 53004) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NC 2016-02462) |
| Enumeration Date | 2009-04-06 |
| Last Update Date | 2022-07-08 |