| NPI | 1629230065 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA 20A10447) |
| Additional Taxonomies | 2084V0102X Psychiatry & Neurology, Vascular Neurology (Licence: CA 20A10447) |
| 2085N0700X Radiology, Neuroradiology (Licence: CA 20A10447) | |
| Enumeration Date | 2008-06-26 |
| Last Update Date | 2023-11-29 |