| NPI | 1184973729 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL TRN16614) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MI 4301105499) |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2019-01-02 |