| NPI | 1184986978 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WA MD60617979) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MA L-252192) |
| Enumeration Date | 2012-06-08 |
| Last Update Date | 2016-02-23 |