| NPI | 1881853158 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MO 2018010679) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MT207746) |
| 207T00000X Neurological Surgery (Licence: RI MD15736) | |
| 207T00000X Neurological Surgery (Licence: FL ME132344) | |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2023-03-31 |