| NPI | 1326428665 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TN 68371) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: FL ME157874) |
| Enumeration Date | 2015-06-02 |
| Last Update Date | 2023-08-10 |