| NPI | 1811103831 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CO 49958) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA A97510) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2012-10-12 |