| NPI | 1568809622 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX T0096) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA A167537) |
| Enumeration Date | 2013-05-30 |
| Last Update Date | 2022-02-10 |