| NPI | 1912252156 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: GA 90427) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TX P6472) |
| 207T00000X Neurological Surgery (Licence: CA A155946) | |
| Enumeration Date | 2012-07-13 |
| Last Update Date | 2023-04-20 |