| NPI | 1760519193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MA 249192) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MO 2014006096) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2021-12-02 |