| NPI | 1649660234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MI 4301502003) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA A176158) |
| Enumeration Date | 2015-02-03 |
| Last Update Date | 2024-09-10 |