| NPI | 1770771529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NC 2016-02005) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: FL ME107320) |
| Enumeration Date | 2007-10-05 |
| Last Update Date | 2020-01-15 |