| NPI | 1326049305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MO R4730) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: KS 04-30268) |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2013-12-13 |