| NPI | 1376686840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX P5938) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WA MD00037874) |
| 207T00000X Neurological Surgery (Licence: NC 2007-01099) | |
| 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 2007-01099) | |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2017-01-24 |