| NPI | 1568429322 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME103266) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MA 219848) |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2012-07-12 |