| NPI | 1609163898 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MD D89573) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TX BP10041718) |
| 207T00000X Neurological Surgery (Licence: GA 080552) | |
| 2085N0700X Radiology, Neuroradiology (Licence: MD D89573) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D89573) | |
| Enumeration Date | 2011-07-07 |
| Last Update Date | 2020-11-04 |