| NPI | 1356558175 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME131814) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: IA R-7346) |
| 207T00000X Neurological Surgery (Licence: IA 39093) | |
| 207T00000X Neurological Surgery (Licence: MN 53831) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2018-08-08 |