| NPI | 1538101746 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OR md13475) |
| Additional Taxonomies | 174400000X Specialist (Licence: OR MD13475) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2010-12-20 |