| NPI | 1669769261 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: RI MD16140) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: AL 36939) |
| Enumeration Date | 2011-07-01 |
| Last Update Date | 2019-05-06 |