| NPI | 1992708663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CO DR.0072591) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: KY 35955) |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2024-03-13 |