| NPI | 1851545875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: VA 0101256777) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NE 28163) |
| Enumeration Date | 2008-11-05 |
| Last Update Date | 2022-12-19 |