| NPI | 1356516074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME133570) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MD 5723) |
| 208600000X Surgery (Licence: MD 5723) | |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2020-08-31 |