| NPI | 1235122193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX K0768) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: AZ 31096) |
| 207T00000X Neurological Surgery (Licence: AR E1597) | |
| Enumeration Date | 2005-08-25 |
| Last Update Date | 2014-08-01 |