| NPI | 1144276288 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA G86263) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NC 2007-01063) |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2017-11-20 |