| NPI | 1528442217 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WI 76593-20) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: SC 38626) |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2022-06-07 |