| NPI | 1851493571 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX G2310) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NC 24630) |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2022-08-25 |