| NPI | 1730279621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA G175077) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MI 4301115254) |
| 207T00000X Neurological Surgery (Licence: WA MD00033972) | |
| 207T00000X Neurological Surgery (Licence: AZ 66853) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2023-06-21 |