| NPI | 1083657910 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: VA 0101240401) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA A060129) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2024-02-06 |