| NPI | 1922268408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA A32050) |
| Additional Taxonomies | 251E00000X Home Health (Licence: CA A32050) |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2014-05-28 |