| NPI | 1689663544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NH 12508) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: VA 0101254853) |
| 207T00000X Neurological Surgery (Licence: MD D0054621) | |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2015-09-09 |