| NPI | 1740399419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: VA 0101038829) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NC 29113) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2007-07-08 |