| NPI | 1982119731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MN 72133) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MN 31677) |
| Enumeration Date | 2017-12-01 |
| Last Update Date | 2022-07-22 |