| NPI | 1639608664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MI 4301112687) |
| Additional Taxonomies | 208600000X Surgery (Licence: MI InProgress) |
| 208600000X Surgery (Licence: MI 4301112687) | |
| Enumeration Date | 2017-06-04 |
| Last Update Date | 2022-07-21 |