| NPI | 1598296055 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: KY 59020) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MN 64189) |
| Enumeration Date | 2017-03-25 |
| Last Update Date | 2024-07-01 |