| NPI | 1245228220 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: DE C10009277) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MD071313L) |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2011-10-11 |