| NPI | 1548757354 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME179384) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA A200111) |
| Enumeration Date | 2018-04-17 |
| Last Update Date | 2026-08-03 |