| NPI | 1912007790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA C142036) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WV 20715) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2022-07-21 |