| NPI | 1366760563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TN 55803) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WA MD.60655602) |
| Enumeration Date | 2010-05-12 |
| Last Update Date | 2017-09-13 |