| NPI | 1891758652 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: LA 322280) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TX J8376) |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2022-01-04 |