| NPI | 1972695195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: FL me143472) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A44736) |
| Enumeration Date | 2006-09-28 |
| Last Update Date | 2020-02-28 |