| NPI | 1285845404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA A142618) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MT203108) |
| Enumeration Date | 2007-05-28 |
| Last Update Date | 2017-08-24 |