| NPI | 1952932766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA 14890535) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: GA 85025) |
| 207T00000X Neurological Surgery (Licence: ZZ 15248) | |
| Enumeration Date | 2020-01-30 |
| Last Update Date | 2021-10-20 |