| NPI | 1134120553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: AL 14044) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: AL 14044) |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2022-07-21 |