| NPI | 1295090488 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME139257) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: FL 17510) |
| Enumeration Date | 2012-07-12 |
| Last Update Date | 2020-12-04 |