| NPI | 1144373739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA A149100) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: AZ 74356) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2025-06-27 |