| NPI | 1053832527 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX R8364) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WI 67216) |
| Enumeration Date | 2017-07-05 |
| Last Update Date | 2025-06-17 |