| NPI | 1710931662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL OS8177) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL OS8177) |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2021-02-22 |