| NPI | 1225024128 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MA 57712) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NH 7608) |
| Enumeration Date | 2005-09-26 |
| Last Update Date | 2020-03-04 |