| NPI | 1689676520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX H2031) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: TX H2031) |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2020-11-16 |