| NPI | 1780806745 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CO 40083) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA A76471) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2023-12-29 |