| NPI | 1356633440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MN 64915) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: FL ME179540) |
| Enumeration Date | 2011-05-06 |
| Last Update Date | 2026-03-02 |