| NPI | 1568637296 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MA 249870) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: RI MD13727) |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2023-09-07 |