| NPI | 1669414587 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA G19631) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: CA G19631) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2007-07-09 |