| NPI | 1619934916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NV 8979) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: AZ 36583) |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2015-07-20 |