| NPI | 1336319623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME157025) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WI 53324) |
| Enumeration Date | 2008-03-03 |
| Last Update Date | 2022-06-14 |