| NPI | 1235651860 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA F494) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA 494) |
| Enumeration Date | 2017-07-14 |
| Last Update Date | 2017-08-04 |