| NPI | 1225262306 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: ID O-0644) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: KS 05-33734) |
| 207T00000X Neurological Surgery (Licence: CO CDR.0000131) | |
| Enumeration Date | 2009-05-05 |
| Last Update Date | 2018-06-20 |