| NPI | 1073893913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: AZ 55155) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: FL ME134842) |
| Enumeration Date | 2011-08-23 |
| Last Update Date | 2020-09-10 |