| NPI | 1619175148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: IA 41128) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: IA R8030) |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2015-07-10 |