| NPI | 1881693133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OR MD23617) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MI 4301066110) |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2021-12-06 |