| NPI | 1447785662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA A156901) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WA MD61468908) |
| Enumeration Date | 2017-04-25 |
| Last Update Date | 2025-08-19 |