| NPI | 1083243265 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME152303) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: FL TRN31104) |
| Enumeration Date | 2020-04-08 |
| Last Update Date | 2024-05-07 |