| NPI | 1730387887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA A84357) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA A84357) |
| 2085N0700X Radiology, Neuroradiology (Licence: CA A84357) | |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2022-07-21 |