| NPI | 1770673253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: GA 038350) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 038350) |
| 207T00000X Neurological Surgery (Licence: AR E-2357) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2022-01-13 |