| NPI | 1013203181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME134385) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ 44801) |
| Enumeration Date | 2011-06-27 |
| Last Update Date | 2018-03-17 |