| NPI | 1053347906 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME0082367) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A65611) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2020-12-04 |