| NPI | 1073975660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CO DR.0073186) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: UT 10964172-1205) |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2026-03-04 |