| NPI | 1538498563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX 45645) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MA 258740) |
| 207T00000X Neurological Surgery (Licence: FL 120509) | |
| Enumeration Date | 2009-12-22 |
| Last Update Date | 2016-09-15 |