| NPI | 1699181891 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME133666) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: SC LL37040) |
| Enumeration Date | 2014-07-08 |
| Last Update Date | 2023-05-15 |