| NPI | 1144584095 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: KY 52106) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: FL ME131513) |
| 207T00000X Neurological Surgery (Licence: FL TRN17374) | |
| Enumeration Date | 2012-06-26 |
| Last Update Date | 2019-01-07 |