| NPI | 1558549295 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: GA 66062) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: VA 0101258506) |
| Enumeration Date | 2008-02-05 |
| Last Update Date | 2020-06-26 |