| NPI | 1548358385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NC 2022-01102) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: FL ME39330) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2022-09-14 |