| NPI | 1619362670 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MN 75185) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CO DR.0067324) |
| Enumeration Date | 2015-04-06 |
| Last Update Date | 2023-09-01 |