| NPI | 1992840813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TN MD36852) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: KY 37599) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2019-05-16 |