| NPI | 1245693654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: AZ 72924) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: FL ME161775) |
| Enumeration Date | 2016-04-01 |
| Last Update Date | 2024-09-24 |