| NPI | 1558568279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME103959) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WI 22650) |
| Enumeration Date | 2007-06-27 |
| Last Update Date | 2022-12-02 |