| NPI | 1609079003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TN MD52181) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MA 254576) |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2022-03-29 |