| NPI | 1528409968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: LA 323676) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MS 963-L) |
| Enumeration Date | 2013-07-15 |
| Last Update Date | 2020-07-22 |