| NPI | 1386134187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA A201729) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MI 4301512073) |
| Enumeration Date | 2018-05-16 |
| Last Update Date | 2026-06-17 |