| NPI | 1124044334 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 87902) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA a87661) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2010-01-12 |