| NPI | 1326255126 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: AR E-7062) | 
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: IA R-7028) | 
| 207T00000X Neurological Surgery (Licence: IA 38401) | |
| Enumeration Date | 2007-05-17 | 
| Last Update Date | 2011-10-04 |