| NPI | 1568773901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CO DR.0069483) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MS 28060) |
| 207T00000X Neurological Surgery (Licence: NE 6354) | |
| Enumeration Date | 2010-06-30 |
| Last Update Date | 2022-10-18 |