| NPI | 1831483825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NC 2020-04137) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MA L-248422) |
| 207T00000X Neurological Surgery (Licence: MA 278430) | |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2024-02-06 |