| NPI | 1699783498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: GA 043612) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: SC 23406) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2020-01-07 |