| NPI | 1831107309 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: LA 325661) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OR MD17696) |
| 207T00000X Neurological Surgery (Licence: WA MD00023061) | |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2021-04-28 |