| NPI | 1417213513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME141057) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OR MD198070) |
| Enumeration Date | 2012-04-03 |
| Last Update Date | 2021-08-06 |