| NPI | 1134418965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME150097) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MD464340) |
| Enumeration Date | 2011-04-01 |
| Last Update Date | 2023-02-02 |