| NPI | 1134502768 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: OK 38065) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: OK 38065) |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2025-05-15 |