| NPI | 1912169350 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WA OP607335641) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OR DO166187) |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2021-04-16 |