| NPI | 1750320511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX K3122) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX K3122) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2020-12-30 |