| NPI | 1114424116 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA A201957) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MI 4351036201) |
| Enumeration Date | 2018-04-07 |
| Last Update Date | 2026-04-07 |