| NPI | 1326064262 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX P9955) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MO BB474578520060130173) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2015-05-18 |