| NPI | 1124033709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: AZ 47834) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: FL ME91980) |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2019-07-12 |