| NPI | 1629089685 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX P4962) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WI 49504-020) |
| 207T00000X Neurological Surgery (Licence: OH 35120598) | |
| 207T00000X Neurological Surgery (Licence: CO DR.0060235) | |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2022-04-06 |