| NPI | 1871583054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TN MD07603) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MS 06669) |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2018-09-11 |