NPI | 1790124691 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MA 284117) |
Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MA MCS004591A) |
207T00000X Neurological Surgery (Licence: MA 281414) | |
Enumeration Date | 2013-06-24 |
Last Update Date | 2020-09-21 |