| NPI | 1386701159 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA G39747) |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care (Licence: CA G39747) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2024-04-26 |