| NPI | 1750370102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX n2379) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: LA 14085r) |
| Enumeration Date | 2005-10-18 |
| Last Update Date | 2014-12-03 |