| NPI | 1861694242 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA A108492) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NC 2019-00262) |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2019-04-05 |