| NPI | 1639106305 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: KS 04-23631) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MO R4P74) |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2010-11-06 |