| NPI | 1609161637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX BP10040651) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: RI MD16116) |
| 207T00000X Neurological Surgery (Licence: TX R9467) | |
| Enumeration Date | 2011-06-17 |
| Last Update Date | 2020-03-09 |