| NPI | 1740265370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: AZ 20665) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MN 30962) |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2020-09-08 |