| NPI | 1275648719 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OR MD17549) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WA MD00034680) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2007-07-08 |