| NPI | 1902841562 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CO DR-37026) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WY 7381A) |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2011-10-06 |