| NPI | 1912190083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA C183051) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MA 276818) |
| 207T00000X Neurological Surgery (Licence: FL ME153587) | |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2023-12-13 |