| NPI | 1104928209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA A103894) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA A103894) |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2010-11-17 |