| NPI | 1801088711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MA 249493) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: KY 55360) |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2021-08-11 |