| NPI | 1114196466 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WA MD60218165) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA A81041) |
| Enumeration Date | 2008-02-20 |
| Last Update Date | 2013-01-03 |