| NPI | 1679672406 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA G81608) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TX M5365) |
| 207T00000X Neurological Surgery (Licence: OH 35-079331) | |
| 207T00000X Neurological Surgery (Licence: CA GFE 81608) | |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2019-05-17 |