| NPI | 1447626791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: AZ 70024) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA xx) |
| 207X00000X Orthopaedic Surgery (Licence: NY 314106) | |
| Enumeration Date | 2015-08-20 |
| Last Update Date | 2023-09-19 |