| NPI | 1366475451 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WV 22744) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: LA 10052R) |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2012-07-06 |