| NPI | 1487973111 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME131977) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MD457008) |
| Enumeration Date | 2010-05-20 |
| Last Update Date | 2021-03-29 |