| NPI | 1770763732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WA MD61154864) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: KS 04-44524) |
| 207T00000X Neurological Surgery (Licence: UT 8866248-1205) | |
| Enumeration Date | 2007-11-07 |
| Last Update Date | 2023-02-28 |