| NPI | 1114381431 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MI 4301512105) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: AZ 69005) |
| Enumeration Date | 2016-04-12 |
| Last Update Date | 2024-07-08 |