| NPI | 1942355854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA A116011) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MD P19058) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2020-09-24 |