| NPI | 1699805291 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MO 2009014888) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MA 53043) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2022-09-02 |