| NPI | 1699033894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WV 3595) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WA OP60929128) |
| Enumeration Date | 2012-04-25 |
| Last Update Date | 2024-01-09 |