| NPI | 1215176839 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: ID M-14514)  | 
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA A109748)  | 
| Enumeration Date | 2009-02-05 | 
| Last Update Date | 2022-01-11 |