| NPI | 1922093863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MA 40193) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 40193) |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2012-11-06 |