| NPI | 1861812372 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX BP10052651) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: RI MD18183) |
| Enumeration Date | 2014-04-23 |
| Last Update Date | 2022-06-26 |