| NPI | 1477538411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: RI MD 08444) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MA 71248) |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2023-03-07 |