| NPI | 1821014648 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX P9030) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: LA 016892) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2014-02-24 |