| NPI | 1619079571 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NC 27482) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: AZ 17725) |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2020-12-17 |