| NPI | 1669884441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME157518) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WV 27090) |
| 207T00000X Neurological Surgery (Licence: AZ 62548) | |
| Enumeration Date | 2014-05-28 |
| Last Update Date | 2022-10-06 |