| NPI | 1467680678 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: SC 39958) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WA MD60530040) |
| 207T00000X Neurological Surgery (Licence: IL 125-056805) | |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2021-04-28 |