| NPI | 1114065646 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME136438) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TX N4123) |
| 207T00000X Neurological Surgery (Licence: PA MD427308) | |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2024-07-24 |