| NPI | 1083669592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA G84805) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CO DR.0054873) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2016-03-17 |