| NPI | 1962475145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: KS 0435556) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MO 2012006599) |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2020-06-03 |