| NPI | 1174513436 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: VA 0101239440) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NC 30888) |
| 207T00000X Neurological Surgery (Licence: MA 58762) | |
| 207T00000X Neurological Surgery (Licence: NH 12520) | |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2007-11-06 |