| NPI | 1023081254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX Q8094) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MO 2005007061) |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2025-12-31 |