| NPI | 1801811047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA G5819) |
| Additional Taxonomies | 208600000X Surgery (Licence: AR G5819) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2010-07-16 |