| NPI | 1700847084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME166111) |
| Additional Taxonomies | 174400000X Specialist (Licence: HI MD5147) |
| 207T00000X Neurological Surgery (Licence: CA MD-5147) | |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2024-08-29 |