| NPI | 1619187697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TN 46082) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TX P0179) |
| 207T00000X Neurological Surgery (Licence: LA 200214) | |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2024-04-03 |