| NPI | 1598183279 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NC 2024-03559) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: FL ME149791) |
| Enumeration Date | 2014-03-31 |
| Last Update Date | 2025-03-26 |