NPI | 1669765426 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MA 279672) |
Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA A155671) |
207T00000X Neurological Surgery (Licence: PA MT199195) | |
Enumeration Date | 2011-05-25 |
Last Update Date | 2019-07-02 |