| NPI | 1609282656 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA A193533) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MO 2014016518) |
| 207T00000X Neurological Surgery (Licence: NV 21168) | |
| Enumeration Date | 2014-07-09 |
| Last Update Date | 2024-02-07 |