| NPI | 1083679252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: GA 056393) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: SC 18840) |
| 207T00000X Neurological Surgery (Licence: TX G5572) | |
| 207T00000X Neurological Surgery (Licence: PA MD425822) | |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2007-07-11 |