| NPI | 1801996442 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: LA MD.201741) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: AR E-4893) |
| 207T00000X Neurological Surgery (Licence: CA A78198) | |
| Enumeration Date | 2006-09-24 |
| Last Update Date | 2011-06-06 |