| NPI | 1184955734 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME140910) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: UT 8573892-1205) |
| 207T00000X Neurological Surgery (Licence: TX BP20025214) | |
| Enumeration Date | 2010-01-21 |
| Last Update Date | 2019-07-16 |