| NPI | 1396854550 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: UT 157130-1205) |
| Additional Taxonomies | 2086S0120X Surgery, Pediatric Surgery (Licence: UT 157130-1205) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2013-11-25 |