| NPI | 1184610875 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MI 4301040395) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MI 4301040395) |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2010-11-04 |