| NPI | 1386910073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: KY 32902) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: VT 0101055449) |
| 207T00000X Neurological Surgery (Licence: UT 291496-1205) | |
| Enumeration Date | 2012-03-27 |
| Last Update Date | 2012-12-27 |