| NPI | 1932104049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL OS8838) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WV 2348) |
| Enumeration Date | 2005-06-15 |
| Last Update Date | 2015-03-09 |