| NPI | 1790734242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TN 40567) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TX V2396) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2024-07-30 |