| 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 |