| NPI | 1174609556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME103822) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: FL TRN10275) |
| Enumeration Date | 2006-10-28 |
| Last Update Date | 2023-03-07 |