| NPI | 1578764213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NC 00607) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: UT 5211128-1205) |
| 207T00000X Neurological Surgery (Licence: MD D65250) | |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2010-07-30 |