| NPI | 1043577901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: AZ 52864) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA A120755) |
| 207T00000X Neurological Surgery (Licence: CO 59358) | |
| Enumeration Date | 2012-04-17 |
| Last Update Date | 2018-12-10 |