| NPI | 1144586116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME143941) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TX S0785) |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2020-06-30 |