| NPI | 1356704019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PA MD485275) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: FL ME163126) |
| Enumeration Date | 2016-03-31 |
| Last Update Date | 2024-06-20 |