| NPI | 1982837084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MA 291698) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: UT 8127589-1252) |
| Enumeration Date | 2009-08-24 |
| Last Update Date | 2022-07-15 |