| NPI | 1114954120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: GA 061885) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TX G8850) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2012-11-30 |