| NPI | 1932175189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: TX G4553) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TX G4553) |
| Enumeration Date | 2006-02-27 |
| Last Update Date | 2023-04-10 |