| NPI | 1780657601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WA MD60550761) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA G067903) |
| 207T00000X Neurological Surgery (Licence: TX N6359) | |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2021-05-19 |