| NPI | 1487855185 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA A123664) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MI 4301088700) |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2013-07-15 |