| NPI | 1386841187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MI 4301090301) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CT 052805) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2021-03-08 |