| NPI | 1780770933 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: GA 066128) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: AR E-6713) |
| 207T00000X Neurological Surgery (Licence: OH 35.096121) | |
| 207T00000X Neurological Surgery (Licence: NY 258033) | |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2011-06-22 |