| NPI | 1700820339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: AL 32484) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: AL 21659) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2023-06-29 |