| NPI | 1154584142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CT 61453) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MA 260811) |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2019-01-24 |