| NPI | 1710923388 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX H0737) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: AR E-6727) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2015-09-29 |