| NPI | 1669429049 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CO 53071) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MO 2001013105) |
| 207T00000X Neurological Surgery (Licence: AR E1615) | |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2015-05-14 |