| NPI | 1326200122 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME133241) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MI 4301103504) |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2023-02-21 |