| NPI | 1932195427 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX M7885) | 
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: AZ 33378) | 
| Enumeration Date | 2005-09-21 | 
| Last Update Date | 2021-12-02 |