| NPI | 1932215308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: AZ 67842) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WA MD60105166) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2024-06-03 |