| NPI | 1063675502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: KY 44127) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: IN 01069466A) |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2014-11-20 |