| NPI | 1790132132 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX U4624) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: IA R-10491) |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2023-08-21 |