| NPI | 1811970726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA A066315) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WA MD60010649) |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: MN 103463) | |
| 207T00000X Neurological Surgery (Licence: FL ME110039) | |
| 207T00000X Neurological Surgery (Licence: KY 43336) | |
| 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: CA A066315) | |
| Enumeration Date | 2005-11-23 |
| Last Update Date | 2011-08-29 |