| NPI | 1124123880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MN 51404) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: FL ME105354) |
| 207T00000X Neurological Surgery (Licence: CA G68540) | |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2020-02-25 |