| NPI | 1659321230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX N6559) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MA 227755) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2015-02-27 |