| NPI | 1487641999 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MI 4301042659) |
| Additional Taxonomies | 174400000X Specialist (Licence: MI 4301042659) |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2013-04-12 |