| NPI | 1912394438 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NY 329722) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA A175755) |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2026-07-06 |