| NPI | 1700874013 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OK 10483) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TX D7028) |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2009-12-16 |