| NPI | 1982660049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME53442) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: FL ME53442) |
| 2086S0129X Surgery, Vascular Surgery (Licence: FL ME53442) | |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2010-04-23 |