| NPI | 1750487823 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX R7022) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MO 2012008248) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2019-12-13 |