| NPI | 1871790691 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TN MD44042) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WV 21722) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2020-04-21 |