| NPI | 1962450023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WA MD00045863) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: VA 0101241128) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2024-04-16 |