| NPI | 1083768139 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CO DR.0056315) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MN 19672) |
| 207T00000X Neurological Surgery (Licence: MI 4301102267) | |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2016-02-08 |