| NPI | 1356720510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 60820) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MN 60820) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 60820) | |
| 207T00000X Neurological Surgery (Licence: WI 22674) | |
| Enumeration Date | 2015-05-21 |
| Last Update Date | 2022-07-26 |