| NPI | 1104825892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: ID M11193) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MN 44711) |
| Enumeration Date | 2005-07-15 |
| Last Update Date | 2013-02-11 |