| NPI | 1760494496 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX N6643) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: FL ME96604) |
| 207T00000X Neurological Surgery (Licence: CA A90741) | |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2018-08-23 |