| NPI | 1891894234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: AL MD.43948) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: FL ME116197) |
| 207T00000X Neurological Surgery (Licence: TN MD37525) | |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2022-05-16 |