| NPI | 1043716913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: ID 6471162) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OR MD225480) |
| Enumeration Date | 2018-04-01 |
| Last Update Date | 2025-08-06 |