| NPI | 1154738326 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NC 2020-04822) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: MI 5101021265) |
| 207T00000X Neurological Surgery (Licence: MI 5315066356) | |
| Enumeration Date | 2014-07-18 |
| Last Update Date | 2025-01-29 |