| NPI | 1740260223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: VA 0101244967) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MO 2001012068) |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2009-07-23 |