| NPI | 1447460985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MA 290789) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: LA MD.206952) |
| 207T00000X Neurological Surgery (Licence: PA MT188443) | |
| 207T00000X Neurological Surgery (Licence: LA 206952) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2022-02-10 |