| NPI | 1679511158 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: AZ 37827) |
| Additional Taxonomies | 174400000X Specialist (Licence: MS 16948) |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2012-02-15 |