| NPI | 1639428238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA A138993) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TX R2158) |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2021-12-03 |