| NPI | 1710906052 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: GA 81965) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: FL ME73991) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2019-01-07 |