| NPI | 1821197252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WV 29856) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TN MD30010) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2022-04-12 |