| NPI | 1083632731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CO 32107) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO 32101) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2018-03-17 |