| NPI | 1841206455 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX L2024) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NM MD2015-0058) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2023-01-09 |