| NPI | 1164818753 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: AR E-16879) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA A175624) |
| 207T00000X Neurological Surgery (Licence: MO 2023030152) | |
| Enumeration Date | 2015-04-09 |
| Last Update Date | 2023-08-29 |