| NPI | 1659420982 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MA 273722) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA G61930) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2018-03-17 |