| NPI | 1083672703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: KY 37283) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: KY 37283) |
| Enumeration Date | 2006-05-02 |
| Last Update Date | 2014-11-20 |