| NPI | 1912382987 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MO 2023011073) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: AR E16446) |
| Enumeration Date | 2015-07-20 |
| Last Update Date | 2023-06-02 |