| NPI | 1104852847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX H9239) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MT 10870) |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2014-06-20 |