| NPI | 1104893015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MD D29422) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: DC 12123) |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2012-05-23 |