| NPI | 1770619165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: RI MD13555) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MA 235417) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2012-04-10 |