| NPI | 1619983962 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TN 0000026843) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: VA 0101056734) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2019-10-18 |