| NPI | 1679552772 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX M7699) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MN 43812) |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2024-03-07 |