| NPI | 1619231594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NC 2019-00971) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: IL 125061753) |
| 207T00000X Neurological Surgery (Licence: FL OS14995) | |
| Enumeration Date | 2012-06-26 |
| Last Update Date | 2020-10-26 |