| NPI | 1851510580 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NE 5058) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: IA MD-38892) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2023-12-15 |