| NPI | 1043413412 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME122350) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: AZ PG 76521) |
| 207T00000X Neurological Surgery (Licence: MI 4301093755) | |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2015-10-22 |