| NPI | 1356476808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NV 4436) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA G033535) |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2007-07-08 |