| NPI | 1467751347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX P5662) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TX BP20029647) |
| Enumeration Date | 2011-03-18 |
| Last Update Date | 2020-02-03 |