| NPI | 1629310883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX T1707) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: GA 101231) |
| Enumeration Date | 2013-03-26 |
| Last Update Date | 2024-08-22 |