| NPI | 1992968218 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MO 2013012524) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TX N9745) |
| 207T00000X Neurological Surgery (Licence: NY 264647) | |
| 208600000X Surgery (Licence: MO 2013012524) | |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2022-09-15 |