| NPI | 1750444907 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME112245) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MD429742) |
| 207T00000X Neurological Surgery (Licence: MO 2011006604) | |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2012-07-31 |