| NPI | 1821109786 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME146515)  | 
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: FL ME146515)  | 
| 207T00000X Neurological Surgery (Licence: IL 036.139412)  | |
| 2086S0102X Surgery, Surgical Critical Care (Licence: FL ME146515)  | |
| Enumeration Date | 2006-08-31 | 
| Last Update Date | 2025-03-14 |