| NPI | 1497067573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA A159281) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MO 2010020726) |
| Enumeration Date | 2010-07-06 |
| Last Update Date | 2019-04-05 |