| NPI | 1558352831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MI 4301054875) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NC 9600051) |
| Enumeration Date | 2005-11-04 |
| Last Update Date | 2024-08-18 |