| NPI | 1760641088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX Q3374) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: IA MD-41845) |
| Enumeration Date | 2008-06-02 |
| Last Update Date | 2021-05-11 |