| NPI | 1588652275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: AR E2551) |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: AR E2551) |
| Enumeration Date | 2005-10-07 |
| Last Update Date | 2007-07-08 |