| NPI | 1750747788 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: CA 126033) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA 126033) |
| Enumeration Date | 2016-01-06 |
| Last Update Date | 2016-01-06 |