| NPI | 1306814868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA A87133) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WA MD00042260) |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2024-09-05 |