| NPI | 1598942609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX M3737) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MI 4301081224) |
| Enumeration Date | 2008-01-31 |
| Last Update Date | 2014-11-19 |