| NPI | 1073957312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: UT 11725328-1205) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA 136637) |
| Enumeration Date | 2013-04-17 |
| Last Update Date | 2022-02-28 |