| NPI | 1396130100 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA A190135) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A190135) |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2024-02-29 |