| NPI | 1508019159 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MN 60157) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA OS014355) |
| 207T00000X Neurological Surgery (Licence: TN 2652) | |
| Enumeration Date | 2008-10-28 |
| Last Update Date | 2020-12-09 |