| NPI | 1841374956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MI 4301091325) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TN MD36607) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2012-11-15 |