| NPI | 1952519704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: LA MD.202324) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: AL 25794) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2018-10-25 |