| NPI | 1003814716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: GA 62853) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: KS 0429019) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2024-01-25 |