| NPI | 1356312797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PA MD037456E) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA BA0768448) |
| Enumeration Date | 2006-02-01 |
| Last Update Date | 2008-02-26 |