| NPI | 1346365871 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OR DO150552) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA 20A9113) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2019-07-29 |