| NPI | 1992110787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: UT 12335173-1205) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MO 2014019153) |
| Enumeration Date | 2014-07-01 |
| Last Update Date | 2021-07-29 |