| NPI | 1770521692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME94748) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MD422097) |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2018-06-25 |