| NPI | 1639378078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA A98972) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MN 75929) |
| 207T00000X Neurological Surgery (Licence: ND 20489) | |
| Enumeration Date | 2007-07-16 |
| Last Update Date | 2024-02-07 |