| NPI | 1891762399 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NC 200000215) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TN 36793) |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2022-10-13 |