| NPI | 1245400167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX R3397) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA 20A9785) |
| Enumeration Date | 2008-03-06 |
| Last Update Date | 2023-06-23 |