| NPI | 1578773990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: GA 069981) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: IA R-7823) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2020-10-14 |