| NPI | 1639499882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME151982) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WI 65888) |
| Enumeration Date | 2010-06-09 |
| Last Update Date | 2021-10-27 |