| NPI | 1750354437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX N1605) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: FL ME91668) |
| Enumeration Date | 2006-02-11 |
| Last Update Date | 2014-02-21 |