| NPI | 1982686630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CO 50312) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TN MD17514) |
| 207T00000X Neurological Surgery (Licence: WY 9812A) | |
| Enumeration Date | 2005-11-17 |
| Last Update Date | 2016-11-17 |