| NPI | 1881677235 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: ND ND7789) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MA 160084) |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2012-11-28 |