| NPI | 1134510589 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WA MD61279013) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA A142420) |
| 207T00000X Neurological Surgery (Licence: FL ME150080) | |
| Enumeration Date | 2015-02-06 |
| Last Update Date | 2022-09-21 |