| NPI | 1083669600 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA G32809) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WA MD60027817) |
| 207T00000X Neurological Surgery (Licence: FL ME88858) | |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2021-02-16 |