| NPI | 1801329602 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MN 76312) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NC 227957) |
| Enumeration Date | 2017-04-07 |
| Last Update Date | 2024-06-05 |