| NPI | 1235323981 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME117533) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: SD 10500) |
| 207T00000X Neurological Surgery (Licence: MI 4301091375) | |
| 207T00000X Neurological Surgery (Licence: NC 2019-00956) | |
| Enumeration Date | 2007-09-05 |
| Last Update Date | 2022-03-30 |