| NPI | 1114977477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME50079) |
| Additional Taxonomies | 174400000X Specialist (Licence: TN MD35799) |
| 207T00000X Neurological Surgery (Licence: ND LT15664) | |
| 207T00000X Neurological Surgery (Licence: GU M-2045) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2021-09-29 |