| NPI | 1942282348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MA 74143) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TX g625865) |
| Enumeration Date | 2005-11-19 |
| Last Update Date | 2021-10-07 |