| NPI | 1053979419 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX V9585) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: TX V9585) |
| Enumeration Date | 2019-05-31 |
| Last Update Date | 2025-06-30 |