NPI | 1962795336 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MA 278233) |
Additional Taxonomies | 207T00000X Neurological Surgery (Licence: VA 0101253072) |
207T00000X Neurological Surgery (Licence: TX R6306) | |
Enumeration Date | 2011-05-18 |
Last Update Date | 2019-09-08 |