| NPI | 1134276959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX Q1519) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WA MD60339323) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2015-10-09 |