| NPI | 1467721142 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WA MD61265065) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA A171977) |
| Enumeration Date | 2011-12-23 |
| Last Update Date | 2022-05-10 |