| NPI | 1760487573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WI 39878) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MN 51338) |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2014-02-10 |