| NPI | 1376783068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA A106673) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WA MD60446688) |
| Enumeration Date | 2009-02-20 |
| Last Update Date | 2018-11-15 |