| NPI | 1528350436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WI 68818-20) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: VA 0101262140) |
| Enumeration Date | 2011-05-11 |
| Last Update Date | 2018-06-27 |