| NPI | 1992789747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA A45489) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OR MD21924) |
| 207T00000X Neurological Surgery (Licence: TX J6902) | |
| 207T00000X Neurological Surgery (Licence: AZ 21671) | |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2022-11-03 |