| NPI | 1306807094 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: GA 61083) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: VA 052894) |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2012-08-09 |