| NPI | 1689052664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: ID M-17423) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WA MD61270647) |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2023-08-31 |