| NPI | 1710993381 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX Q0224) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CT 023954) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2020-12-08 |