| NPI | 1083721971 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NC 2024-03140) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CO DR.0058196) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2025-05-09 |