| NPI | 1689818346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CO DR.0069008) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NC 2016-00021) |
| Enumeration Date | 2009-04-26 |
| Last Update Date | 2022-07-29 |