| NPI | 1922444371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CT 67453) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA A168627) |
| Enumeration Date | 2013-05-13 |
| Last Update Date | 2021-06-14 |