| NPI | 1932383205 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX P6733) | 
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: GA 002279) | 
| Enumeration Date | 2007-12-21 | 
| Last Update Date | 2021-01-25 |