| NPI | 1972754927 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: LA 332737) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA A99882) |
| Enumeration Date | 2008-10-08 |
| Last Update Date | 2022-10-14 |