| NPI | 1255494704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME88243) |
| Additional Taxonomies | 2086S0102X Surgery Surgical Critical Care (Licence: FL ME88243) |
| 2086S0127X Surgery Trauma Surgery (Licence: FL ME88243) | |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2013-06-19 |