| NPI | 1558328278 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MD D60572) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NC 200600270) |
| 207T00000X Neurological Surgery (Licence: TX N9655) | |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2018-03-17 |