| NPI | 1255759072 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA A140375) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MD D91406) |
| Enumeration Date | 2014-03-29 |
| Last Update Date | 2022-07-25 |