| NPI | 1760618862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MT 158821) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MN 53946) |
| 207T00000X Neurological Surgery (Licence: ME DO2118) | |
| Enumeration Date | 2009-06-03 |
| Last Update Date | 2025-05-06 |