| NPI | 1881985323 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME151082) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: AZ 55781) |
| Enumeration Date | 2011-05-02 |
| Last Update Date | 2021-07-22 |