| NPI | 1851772990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CO DR.0068415) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: SC 38290) |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2022-05-20 |