| NPI | 1770112583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MN 69630) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MN 30896) |
| Enumeration Date | 2020-04-03 |
| Last Update Date | 2021-08-24 |