| NPI | 1811181886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: OR MF158565) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OR MF158565) |
| 207T00000X Neurological Surgery (Licence: WA FE60400372) | |
| 207T00000X Neurological Surgery (Licence: NM RS2013 0037) | |
| Enumeration Date | 2007-08-31 |
| Last Update Date | 2021-12-01 |