| NPI | 1841639986 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MI 4301106303) |
| Additional Taxonomies | 208600000X Surgery (Licence: AZ R74068) |
| Enumeration Date | 2013-06-21 |
| Last Update Date | 2015-12-22 |