| NPI | 1467460923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WA MD00045323) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OR MD26582) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2018-08-07 |