| NPI | 1174551949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME102413) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CO 38706) |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2014-11-12 |