| NPI | 1366497950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MI 4301093588) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 235388) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2012-08-03 |