| NPI | 1669677514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME124983) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MO 2007015723) |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2019-08-13 |