| NPI | 1669472577 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: TX L7561) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TX L7561) |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2023-06-26 |