| NPI | 1326144049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: SC 36509) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MI 4301088644) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2016-12-14 |