| NPI | 1851368765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MN 74238) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: VA 0101242325) |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2023-07-12 |