| NPI | 1447236187 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NC 28417) | 
| Additional Taxonomies | 174400000X Specialist (Licence: NC 284174) | 
| Enumeration Date | 2005-12-15 | 
| Last Update Date | 2013-07-08 |