| NPI | 1871764258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: DC MD036651) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TN 43435) |
| Enumeration Date | 2008-03-13 |
| Last Update Date | 2010-09-27 |