| NPI | 1518348655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NC 2022-00838) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MO 2015017157) |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2023-08-30 |