| NPI | 1104016252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME108649) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: FL 11432) |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2022-07-20 |