| NPI | 1982681409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MI 4301052399) |
| Additional Taxonomies | 174400000X Specialist (Licence: MI 4301052399) |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2016-10-27 |