| NPI | 1427265248 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WA MD60693605) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: IA 32709) |
| 207T00000X Neurological Surgery (Licence: PA MD436241) | |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2017-04-26 |