| NPI | 1457449100 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME107703) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: VA 0101034243) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2022-02-09 |