| NPI | 1528418894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: LA 330615) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MI 5101025301) |
| Enumeration Date | 2016-06-17 |
| Last Update Date | 2022-09-19 |