| NPI | 1053428326 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NC 2006-01048) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2006-01048) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2008-06-25 |