| NPI | 1629459748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: VA 0102208468) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: GA 95670) |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2024-06-06 |