| NPI | 1497191985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX S8352) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MI 4301501336) |
| Enumeration Date | 2013-05-11 |
| Last Update Date | 2021-07-02 |