| NPI | 1043310006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX 41851) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TX M7937) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2026-06-23 |