| NPI | 1881058741 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME162424) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: UT 11758955-1205) |
| Enumeration Date | 2016-04-07 |
| Last Update Date | 2023-06-16 |