| NPI | 1962487520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CT 032506) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CT 032506) |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2008-04-24 |