| NPI | 1467694844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MT MED-PHYS-LIC-47708) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CO DR49400) |
| Enumeration Date | 2009-03-31 |
| Last Update Date | 2022-02-22 |