| NPI | 1639598832 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: KS 04-46540) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: KS pend) |
| 207T00000X Neurological Surgery (Licence: MO 2022041378) | |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2023-05-30 |