| NPI | 1831129634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: IA DO-05563) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MO 2005034466) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2020-05-14 |