| NPI | 1295421428 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME161227) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL ME161227) |
| Enumeration Date | 2023-04-12 |
| Last Update Date | 2023-11-08 |