| NPI | 1740644830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME133248) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: GA 75605) |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2021-03-18 |