| NPI | 1477654937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: VA 0101263843) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: KY 37372) |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2023-08-28 |