| NPI | 1649216920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: SD 8903) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: IA 35686) |
| 207T00000X Neurological Surgery (Licence: WI 35850) | |
| 207T00000X Neurological Surgery (Licence: NE 27413) | |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2016-05-11 |