| NPI | 1811036825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: VA 0101281701) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: FL ME113481) |
| 207T00000X Neurological Surgery (Licence: NM MD2011-0265) | |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2024-07-10 |