| NPI | 1598940686 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NC 2018-01776) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MS 21001) |
| Enumeration Date | 2008-01-08 |
| Last Update Date | 2018-09-06 |