| NPI | 1750591350 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OR 154195) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OR LL16519) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2022-02-04 |