| NPI | 1134123862 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX E3846) |
| Additional Taxonomies | 208600000X Surgery (Licence: TX E3846) |
| Enumeration Date | 2005-06-10 |
| Last Update Date | 2012-11-27 |