| NPI | 1972803120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: AZ 72029) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WA 60750493) |
| Enumeration Date | 2010-10-21 |
| Last Update Date | 2024-08-20 |