| NPI | 1528796869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME170429) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: IL 036.173112) |
| Enumeration Date | 2022-08-14 |
| Last Update Date | 2025-01-13 |