| NPI | 1679004972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA A202222) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: RI LP04320) |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2025-08-01 |