| NPI | 1760744460 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: AZ 59734) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WI 71969-20) |
| Enumeration Date | 2012-06-09 |
| Last Update Date | 2024-01-16 |