| NPI | 1528063161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NM 97-21) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: AZ 62063) |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2021-08-25 |