| NPI | 1700952744 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX S9627) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: LA 205122) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2021-03-16 |