| NPI | 1295780278 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OR MD23720) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WA MD40839) |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2007-10-10 |