| NPI | 1457354383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: SD 2820) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: IA 25079) |
| 207T00000X Neurological Surgery (Licence: NE 18422) | |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2014-01-14 |