NPI | 1518251834 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MA 295007) |
Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WA MD61125187) |
Enumeration Date | 2011-06-03 |
Last Update Date | 2022-11-02 |