| NPI | 1942385703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: LA MD.203804) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: FL TRN6823) |
| 207T00000X Neurological Surgery (Licence: FL ME105666) | |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2020-03-25 |