| NPI | 1124482815 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CO DR.0071013) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OR MD222114) |
| Enumeration Date | 2016-04-08 |
| Last Update Date | 2025-04-21 |