| NPI | 1538522404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WV 33770) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WA MD61406690) |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2024-07-22 |