| NPI | 1740396621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MT 18630) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CO RT1498) |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2018-06-18 |