| NPI | 1225370869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME149776) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MD457777) |
| Enumeration Date | 2013-03-21 |
| Last Update Date | 2023-01-13 |