| NPI | 1538426549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA c200337) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CO DR.0062471) |
| 207T00000X Neurological Surgery (Licence: OR MD223385) | |
| Enumeration Date | 2012-04-15 |
| Last Update Date | 2025-07-30 |