| NPI | 1265475727 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO 106003) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MO 106003) |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2013-01-15 |