| NPI | 1730228750 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WA MD60101113) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NM 2004-0186) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2024-02-08 |