| NPI | 1578819108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: KY 52701) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: KY R2987) |
| Enumeration Date | 2012-08-01 |
| Last Update Date | 2020-06-09 |