| NPI | 1023093218 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: AZ 29324) | 
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA 70638) | 
| Enumeration Date | 2005-12-09 | 
| Last Update Date | 2025-02-26 |