| NPI | 1831199074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OR MD15097) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA G57530) |
| 207T00000X Neurological Surgery (Licence: WI 23998) | |
| Enumeration Date | 2005-07-29 |
| Last Update Date | 2007-07-08 |