| NPI | 1578042354 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA SPI765) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MA 288372) |
| 207T00000X Neurological Surgery (Licence: OH 57.245250) | |
| Enumeration Date | 2018-08-12 |
| Last Update Date | 2024-04-26 |