| NPI | 1649460999 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MS 23739) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MO 2012006604) |
| Enumeration Date | 2007-08-01 |
| Last Update Date | 2016-06-29 |