| NPI | 1174056485 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: CA A161659) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: AZ 72013) |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2026-05-19 |