| NPI | 1144233966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WA MD00027304) |
| Additional Taxonomies | 208600000X Surgery (Licence: WA MD00027304) |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2019-06-04 |