| NPI | 1699034371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: VA 0101268498) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WA MD60891443) |
| Enumeration Date | 2012-05-15 |
| Last Update Date | 2023-02-02 |