| NPI | 1881633709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX J3925) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: VA 0101049207) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2022-03-21 |