| NPI | 1891143301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OR MD217130) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: IA R-10517) |
| Enumeration Date | 2016-05-25 |
| Last Update Date | 2023-06-27 |