| NPI | 1639426968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MN 55688) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MN 106259) |
| Enumeration Date | 2012-08-06 |
| Last Update Date | 2012-10-11 |