| NPI | 1891728788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA A87654) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NH 14974) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2012-03-22 |