| NPI | 1689871998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MO 2013002837) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: FL ME113266) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2013-02-27 |