| NPI | 1578859484 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME135498) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: IA R9287) |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2020-09-01 |