| NPI | 1720059108 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WI 56009) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MN 46666) |
| 207T00000X Neurological Surgery (Licence: NV 13456) | |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2024-01-25 |