| NPI | 1902845100 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX F1977) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MD D0062871) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2020-02-05 |