| NPI | 1942305602 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL ME112041) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA G59443) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2017-01-17 |