| NPI | 1720101827 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NC 2022-01028) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WA MD60167548) |
| 207T00000X Neurological Surgery (Licence: MO 2014006170) | |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2022-08-16 |