| NPI | 1871026823 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: PA MD488312) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA A193315) |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2025-07-24 |