| NPI | 1932179454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: VA 0102201820) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0102-201820) |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2008-06-18 |