| NPI | 1093701872 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: TX F9059) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: CA G43862) |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2026-04-06 |