| NPI | 1356515738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: VA 0101258551) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: LA 206838) |
| Enumeration Date | 2008-04-17 |
| Last Update Date | 2015-07-22 |