| NPI | 1881725984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WA MD60264102) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: UT 4978800-1205) |
| 207T00000X Neurological Surgery (Licence: OR MD28459) | |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2015-09-02 |