| NPI | 1477997971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MA T1015902) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MD470160) |
| Enumeration Date | 2013-04-26 |
| Last Update Date | 2023-04-10 |