| NPI | 1093987067 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX Q6578) | 
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WI 63629-20) | 
| 207X00000X Orthopaedic Surgery (Licence: WI 63629-20) | |
| Enumeration Date | 2008-03-30 | 
| Last Update Date | 2016-09-12 |