| NPI | 1720044415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MS 20326) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TN MD40688) |
| 207T00000X Neurological Surgery (Licence: TX R5058) | |
| 207T00000X Neurological Surgery (Licence: GU M-2439) | |
| Enumeration Date | 2006-04-22 |
| Last Update Date | 2024-08-08 |