| NPI | 1750676524 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: SC 83970) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: KY 51588) |
| Enumeration Date | 2011-06-09 |
| Last Update Date | 2022-01-26 |