| NPI | 1982862942 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: WA Md61174359) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MN 62871) |
| 207T00000X Neurological Surgery (Licence: CA A129466) | |
| Enumeration Date | 2008-05-27 |
| Last Update Date | 2021-10-12 |