| NPI | 1588852610 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NE 32975) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA A86867) |
| Enumeration Date | 2007-10-15 |
| Last Update Date | 2021-03-08 |