| NPI | 1447244298 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WI 53747) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MN 50551) |
| Enumeration Date | 2005-09-08 |
| Last Update Date | 2013-02-22 |