| NPI | 1093976995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NC 2019-01403) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: SC 36597) |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2025-08-07 |