| NPI | 1871819268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX R3073) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NH 18957) |
| Enumeration Date | 2010-04-11 |
| Last Update Date | 2018-06-13 |