| NPI | 1740363837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: VA 0101242977) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: FL ME92657) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2008-07-30 |