| NPI | 1568584159 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX P5247) | 
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA A94626) | 
| Enumeration Date | 2007-04-04 | 
| Last Update Date | 2019-10-24 |