| NPI | 1033373998 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: AZ 45540) | 
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: AZ R70169) | 
| 207T00000X Neurological Surgery (Licence: MI 4301108590) | |
| Enumeration Date | 2008-07-10 | 
| Last Update Date | 2022-10-25 |