| NPI | 1306911045 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MI 4301062472) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MI 062472) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301062472) | |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2020-03-31 |