| NPI | 1912978560 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WA MD00027462) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WA 00027462) |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2013-02-20 |