| NPI | 1588892533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MA 274692) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MI 4301111352) |
| Enumeration Date | 2009-06-29 |
| Last Update Date | 2018-08-09 |