| NPI | 1366591778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CT 51554) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MA 250612) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2014-09-03 |