| NPI | 1760402614 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA C54726) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MD427462) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2024-04-26 |