| NPI | 1841218278 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME150797) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MO 2003005880) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2026-06-30 |