| NPI | 1891887246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: VT 042.0013452) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NH 14882) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2016-09-02 |