| NPI | 1689646796 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA C55884) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NC 2006-01182) |
| 207T00000X Neurological Surgery (Licence: TX L5348) | |
| 207T00000X Neurological Surgery (Licence: NV 17760) | |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2019-02-07 |