| NPI | 1376530337 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MA 213682) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: RI MD13119) |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2020-04-23 |