| NPI | 1861798944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME165700) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: SC LL34520) |
| 207T00000X Neurological Surgery (Licence: CA A155607) | |
| 207T00000X Neurological Surgery (Licence: AL 35846) | |
| Enumeration Date | 2011-02-07 |
| Last Update Date | 2024-01-12 |