| NPI | 1932196128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MA 218030) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NH 12042) |
| Enumeration Date | 2005-10-03 |
| Last Update Date | 2020-03-04 |