| NPI | 1508859745 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NC 39005) |
| Additional Taxonomies | 174400000X Specialist (Licence: NC 39005) |
| Enumeration Date | 2005-08-23 |
| Last Update Date | 2014-05-09 |