| NPI | 1457337230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MI 4301071763) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: FL ME135993) |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2025-08-18 |