| NPI | 1770588626 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: GA 83677) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: FL ME81052) |
| 207T00000X Neurological Surgery (Licence: OK 33547) | |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2020-02-18 |