| NPI | 1518456078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA 20A17841) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: ND 24592) |
| Enumeration Date | 2018-05-09 |
| Last Update Date | 2026-09-04 |