| NPI | 1942524590 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX R7270) | 
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: AZ 53433) | 
| Enumeration Date | 2010-03-24 | 
| Last Update Date | 2018-08-23 |