| NPI | 1013131275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: AR E4731) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: AZ 63483) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2025-09-18 |