| NPI | 1831373042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX N1852) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CT 046921) |
| Enumeration Date | 2007-12-24 |
| Last Update Date | 2019-01-31 |