| NPI | 1013235183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX T0362) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: NY 277330) |
| Enumeration Date | 2010-05-13 |
| Last Update Date | 2025-12-23 |