| NPI | 1285704429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: GA 037331) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: VT 042-0009379) |
| 207T00000X Neurological Surgery (Licence: IL 036-079341) | |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2010-07-21 |