| NPI | 1164442059 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME80224) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CO 42697) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2021-04-28 |