| NPI | 1801891411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: GA 063870) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: FL 87176) |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2019-07-22 |