| NPI | 1558628412 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL 135974) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OH 35.122080) |
| 207T00000X Neurological Surgery (Licence: VA 0101267141) | |
| Enumeration Date | 2012-04-17 |
| Last Update Date | 2024-08-12 |