| NPI | 1174740344 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: GA 069603) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: RI LP00899) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2013-07-10 |