| NPI | 1477841385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME142713) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TX S0207) |
| 207T00000X Neurological Surgery (Licence: CA A149288) | |
| 207T00000X Neurological Surgery (Licence: MS T2473) | |
| Enumeration Date | 2011-07-12 |
| Last Update Date | 2019-11-14 |