| NPI | 1013182294 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: VA 0101253928) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MD D0075270) |
| Enumeration Date | 2008-04-28 |
| Last Update Date | 2026-07-11 |