| NPI | 1407199631 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: GA 88699) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: RI MD16896) |
| Enumeration Date | 2013-04-06 |
| Last Update Date | 2021-07-30 |