| NPI | 1740593979 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MO 2017013117) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: KS 04-40058) |
| 207T00000X Neurological Surgery (Licence: NE 6270) | |
| 208600000X Surgery (Licence: NE 6270) | |
| Enumeration Date | 2010-07-16 |
| Last Update Date | 2017-07-14 |