| NPI | 1437380342 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: LA 323556) | 
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA A117597) | 
| Enumeration Date | 2009-07-28 | 
| Last Update Date | 2020-07-03 |