| NPI | 1023267267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX U2643) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MA 234189) |
| 207T00000X Neurological Surgery (Licence: MN 60928) | |
| Enumeration Date | 2008-09-11 |
| Last Update Date | 2026-06-23 |