| NPI | 1710183090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WV 25659) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: AR E-7066) |
| 207T00000X Neurological Surgery (Licence: VA 0101249454) | |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2022-04-08 |