| NPI | 1457512303 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: SC 30808) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: SC LL 30808) |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2015-06-25 |