| NPI | 1285736702 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: SC 32617) |
| Additional Taxonomies | 174400000X Specialist (Licence: SC 632617) |
| Enumeration Date | 2006-09-04 |
| Last Update Date | 2020-01-27 |