| NPI | 1548201346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WA MD60030878) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MD D0059026) |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2023-08-09 |