| NPI | 1508124918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA A169139) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MA 271481) |
| Enumeration Date | 2012-04-24 |
| Last Update Date | 2021-06-16 |