| NPI | 1417247164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CO 21871) |
| Additional Taxonomies | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: CO 21871) |
| Enumeration Date | 2011-04-14 |
| Last Update Date | 2011-04-14 |