| NPI | 1376688150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: SD 7024) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: IA 37278) |
| 207T00000X Neurological Surgery (Licence: NE 4526) | |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2018-07-30 |