| NPI | 1740627579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: GA 90509) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MA 255243) |
| 207T00000X Neurological Surgery (Licence: MO 2021000734) | |
| Enumeration Date | 2013-06-03 |
| Last Update Date | 2024-08-23 |