| NPI | 1790702363 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TN 16614) |
| Additional Taxonomies | 174400000X Specialist (Licence: TN 016614) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2021-04-14 |