| NPI | 1679510705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: GA 90688) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TN 36263) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2024-01-24 |