| NPI | 1184005373 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WA MD61446144) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA A176072) |
| 207T00000X Neurological Surgery (Licence: IL 125067081) | |
| Enumeration Date | 2015-06-12 |
| Last Update Date | 2023-12-07 |