| NPI | 1649461955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CO 50918) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WA MD00045961) |
| Enumeration Date | 2007-08-05 |
| Last Update Date | 2021-06-14 |