| NPI | 1750348777 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: NC 2013-02164) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: SC 15420) |
| 207T00000X Neurological Surgery (Licence: NC 2013-02164) | |
| 208600000X Surgery (Licence: NC 2013-02164) | |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2023-09-26 |