| NPI | 1245435858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MA 250761) |
| Additional Taxonomies | 208600000X Surgery (Licence: MA L-231911) |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2013-08-28 |