| NPI | 1134180177 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME80755) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA G86294) |
| 207T00000X Neurological Surgery (Licence: MI 4301062484) | |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2012-12-18 |