| NPI | 1558742064 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA A191255) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MA L-263836) |
| 207T00000X Neurological Surgery (Licence: MA 291544) | |
| Enumeration Date | 2015-06-11 |
| Last Update Date | 2023-09-30 |