| NPI | 1366601593 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MS 20664) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MS T-1637) |
| Enumeration Date | 2008-06-03 |
| Last Update Date | 2014-03-10 |