| NPI | 1245371400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TN MD13445) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA C33599) |
| 207T00000X Neurological Surgery (Licence: TX D7126) | |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2007-07-08 |