| NPI | 1760740450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PA MD467385) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA A129849) |
| Enumeration Date | 2012-05-01 |
| Last Update Date | 2019-06-26 |