| NPI | 1801438031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CT 63811) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: ZZ 2010815) |
| Enumeration Date | 2019-10-09 |
| Last Update Date | 2020-03-11 |