| NPI | 1790072106 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA A124325) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: FL ME144769) |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2024-02-09 |