| NPI | 1295857555 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX Q5623) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MO 2004016472) |
| 207T00000X Neurological Surgery (Licence: FL ME112535) | |
| Enumeration Date | 2007-04-05 |
| Last Update Date | 2020-01-30 |