| NPI | 1689868119 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WA MD60323860) |
| Additional Taxonomies | 174400000X Specialist (Licence: WA 60323860) |
| Enumeration Date | 2007-08-28 |
| Last Update Date | 2021-05-25 |