| NPI | 1922239268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WA ML60087055) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TX R4601) |
| Enumeration Date | 2009-08-04 |
| Last Update Date | 2024-08-02 |