| NPI | 1710305495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME156147) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NC 301118) |
| Enumeration Date | 2014-03-31 |
| Last Update Date | 2023-12-26 |