| NPI | 1215145396 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OR MD150874) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WA MD60137849) |
| Enumeration Date | 2007-05-20 |
| Last Update Date | 2010-07-19 |