| NPI | 1760478663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MA 27515) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NH 4657) |
| Enumeration Date | 2005-09-26 |
| Last Update Date | 2007-07-09 |