| NPI | 1003158486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CT 069261) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA A169594) |
| Enumeration Date | 2013-03-22 |
| Last Update Date | 2022-07-11 |