| NPI | 1013989383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MO R4609) |
| Additional Taxonomies | 174400000X Specialist (Licence: MO R4609) |
| 174400000X Specialist (Licence: KS 04-15463) | |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2010-04-15 |