| NPI | 1609861392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CO DR0059227) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: FL ME68033) |
| Enumeration Date | 2005-09-19 |
| Last Update Date | 2021-02-24 |