| NPI | 1316136377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME 114507) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TN 49453) |
| Enumeration Date | 2007-10-16 |
| Last Update Date | 2019-09-25 |