| NPI | 1013061084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME128749) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MN 48216) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2016-08-04 |