| NPI | 1912050980 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: AR E-9196) |
| Additional Taxonomies | 174400000X Specialist (Licence: MO 2002010422) |
| Enumeration Date | 2007-01-20 |
| Last Update Date | 2021-01-08 |