| NPI | 1053724880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OR DO214044) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA 20A14588) |
| 207T00000X Neurological Surgery (Licence: CT 69415) | |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2023-01-10 |