| NPI | 1972602431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NC 2022-01303) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MA 204718) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2022-09-26 |