| NPI | 1477034411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WI 71058) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: MN 64239) |
| Enumeration Date | 2018-08-28 |
| Last Update Date | 2023-03-16 |