| NPI | 1831151760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: MA 226751) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MA 226751) |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2022-03-31 |