| NPI | 1548436660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: KY 49416) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TX Q4340) |
| Enumeration Date | 2008-05-08 |
| Last Update Date | 2019-04-24 |