| NPI | 1740301621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: VA 0101231842) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: FL ME102389) |
| 207T00000X Neurological Surgery (Licence: MO 2006007887) | |
| 207T00000X Neurological Surgery (Licence: MD D69761) | |
| 207T00000X Neurological Surgery (Licence: TN MD0000044881) | |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2021-07-12 |