| NPI | 1609261759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME157349) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: UT 10158405-1205) |
| Enumeration Date | 2015-04-04 |
| Last Update Date | 2022-07-12 |