| NPI | 1710961347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MI 4301065499) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA A8159) |
| 207T00000X Neurological Surgery (Licence: WA MD00039713) | |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2023-11-27 |