| NPI | 1942429394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: SD 8072) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NE 30068) |
| 207T00000X Neurological Surgery (Licence: IA MD-43307) | |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2022-07-21 |