| NPI | 1912089533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: GA 045569) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 045569) |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2018-06-07 |