| NPI | 1811986763 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NH 8619) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: GA 64835) |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2014-02-28 |