| NPI | 1548847502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MN 72015) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MN 31598) |
| Enumeration Date | 2021-03-25 |
| Last Update Date | 2022-08-11 |