| NPI | 1093003683 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MA 271688) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA Ot014048) |
| Enumeration Date | 2011-07-15 |
| Last Update Date | 2017-11-06 |