| NPI | 1689171597 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MN 66431) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MN 29167) |
| Enumeration Date | 2018-04-07 |
| Last Update Date | 2020-08-27 |