| NPI | 1689756447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME160926) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CT 55704) |
| 207T00000X Neurological Surgery (Licence: GA 43909) | |
| 207T00000X Neurological Surgery (Licence: MA 156313) | |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2023-08-04 |