| NPI | 1629056908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX N1052) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MN 44797) |
| Enumeration Date | 2006-01-06 |
| Last Update Date | 2014-10-13 |