| NPI | 1982637831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME125571) |
| Additional Taxonomies | 174400000X Specialist (Licence: MS 14878) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2023-01-26 |