| NPI | 1972761211 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA A114866) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA A114866) |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2020-05-26 |