| NPI | 1033234562 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MA 273253) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: FL ME178416) |
| 207T00000X Neurological Surgery (Licence: CA A117012) | |
| 207T00000X Neurological Surgery (Licence: MO 2007004395) | |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2026-08-13 |