| NPI | 1013178425 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX 42327) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: FL ME 102630) |
| 207T00000X Neurological Surgery (Licence: TX P2381) | |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2013-12-12 |