| NPI | 1245584655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA F302) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA LT00072) |
| Enumeration Date | 2012-11-07 |
| Last Update Date | 2014-07-24 |