| NPI | 1609823780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: AR E0433) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TX H7718) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2007-07-08 |