| NPI | 1609051473 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: CA A37018) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA A37018) |
| Enumeration Date | 2007-12-29 |
| Last Update Date | 2024-08-15 |