| NPI | 1740418821 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME130180) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: IL 125.056613) |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2022-07-21 |