| NPI | 1154391589 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MI 4301087004) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA A-70278) |
| 207T00000X Neurological Surgery (Licence: CO DR.0054621) | |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2023-07-18 |