| NPI | 1326063637 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WA MD00037143) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WA MD00042040) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2010-12-03 |