| NPI | 1881801694 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: ND 12888) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: IA R-7901) |
| 207T00000X Neurological Surgery (Licence: IA 40454) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2022-12-30 |