| NPI | 1437376878 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MI 4301099828) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MT189478) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2012-02-03 |